• Title/Summary/Keyword: nonsurgical endodontic treatment

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Ingestion and surgical retrieval of an endodontic file: a case report

  • Devon Marta Ptak;Elinor Alon;Robert Bruce Amato;Julia Tassinari;Adrian Velasquez
    • Restorative Dentistry and Endodontics
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    • v.48 no.4
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    • pp.32.1-32.8
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    • 2023
  • Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide nonsurgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist's office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.

Endodontic management of a C-shaped maxillary first molar with three independent buccal root canals by using cone-beam computed tomography

  • Karanxha, Lorena;Kim, Hee-Jin;Hong, Sung-Ok;Lee, Wan;Kim, Pyung-Sik;Min, Kyung-San
    • Restorative Dentistry and Endodontics
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    • v.37 no.3
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    • pp.175-179
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    • 2012
  • The aim of this study was to present a method for endodontic management of a maxillary first molar with unusual C-shaped morphology of the buccal root verified by cone-beam computed tomography (CBCT) images. This rare anatomical variation was confirmed using CBCT, and nonsurgical endodontic treatment was performed by meticulous evaluation of the pulpal floor. Posttreatment image revealed 3 independent canals in the buccal root obturated efficiently to the accepted lengths in all 3 canals. Our study describes a unique C-shaped variation of the root canal system in a maxillary first molar, involving the 3 buccal canals. In addition, our study highlights the usefulness of CBCT imaging for accurate diagnosis and management of this unusual canal morphology.

The significance of diagnosis and treatment planning in periapical lesion overfilled with calcium hydroxide paste (수산화칼슘제재의 과충전이 발생한 치근단 병소 증례에서 진단과 치료 계획의 중요성)

  • Jung, Kyoung-Hwa;Kwon, Eun-Young;Choi, Youn-Kyung;Kim, So-Yeun;Jeon, Hye-Mi;Park, Jeong-Kil
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.2
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    • pp.95-100
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    • 2021
  • Calcium hydroxide has been widely used for root canal dressing material in endodontic treatment. This report describes that when the accurate diagnosis and proper nonsurgical endodontic retreatment is applied to periapical lesion with accidentally extruded calcium hydroxide paste, the lesion can be successfully treated. Overfilled calcium hydroxide can affect the healing process, so the overextension of calcium hydroxide agent should be avoided.

Surgical management of a failed internal root resorption treatment: a histological and clinical

  • Asgary, Saeed;Eghbal, Mohammad Jafar;Mehrdad, Leili;Kheirieh, Sanam;Nosrat, Ali
    • Restorative Dentistry and Endodontics
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    • v.39 no.2
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    • pp.137-142
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    • 2014
  • This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

Non-surgical root canal treatment of maxillary second premolar fused paramolar tubercle (Paramolar tubercle이 융합된 상악 제2소구치의 비외과적 근관치료)

  • Choi, Da-Kyung;Chang, Hoon-Sang;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann;Park, Chan;Lee, Bin-Na
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.268-273
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    • 2021
  • Paramolar tubercle is a rare developmental dental anomaly defined as an additional cusp occurring on the buccal or lingual surfaces of the molar. Permanent molar fused with paramolar tubercles can be a cause of difficulty in root canal treatment. Therefore, proper understanding of these variations is important in order to ensure successful endodontic treatment. Cone beam computed tomography (CBCT) can be helpful to understand anatomy of complicated cases. This case report describes nonsurgical endodontic treatment of maxillary second premolar fused with paramolar tubercle.

Clinical management of a fused upper premolar with supernumerary tooth: a case report

  • Cho, Kyu-Min;Jang, Ji-Hyun;Park, Sang-Hyuk
    • Restorative Dentistry and Endodontics
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    • v.39 no.4
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    • pp.319-323
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    • 2014
  • In dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.). The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.

CONSERVATIVE APPROACH OF IATROGENIC ROOT PERFORATION (IATROGENIC ROOT PERFORATION의 보존적 접근)

  • Baik, Byeoung-Ju;Jeon, So-Hee;Park, Jeong-Yeol;Kwon, Byoung-Woo;Kim, Jae-Gon;Lee, Yong-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.59-65
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    • 2004
  • Root perforations that result in a communication of the root space with the periodontal tissues occasionally occur during endodontic procedures. They may be induced iatrogenically. Successful treatment depends mainly on immediate sealing of the perforation and prevention of infection. Several factors affect the achievement of these goals, most important of which are time of occurrence, size and location of the perforation. Identification of root perforations is possible by direct observation of bleeding, radiography and an apex locator. Perforation defects may be repaired by nonsurgical or surgical techniques. We report two cases of root perforation. One was treated by glass ionomer, other was treated by composite resin with calcium hydroxide.

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A NEW POST REMOVAL TECHNIQUE USING ATD TUGGING DEVICE (ATD automatic bridge remover를 이용한 새로운 포스트 제거 방법)

  • Park, Yun-Woo;Park, Se-Hee;Shin, Hye-Jin;Cho, Kyung-Mo;Kim, Jin-Woo
    • Restorative Dentistry and Endodontics
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    • v.30 no.3
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    • pp.215-220
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    • 2005
  • It is common for clinicians to encounter endodontically tl·treated teeth that contain posts within their roots. If endodontic treatment is failed, these posts must be removed to facilitate successful nonsurgical retreatment. There have been many techniques such as ultrasonic instrument, Ruddle post removal system, Eggler post remover and Masserann kit developed to facilitate removal of posts from the root canal space. But these methods may be disadvantageous because long length of time required for post removal and fracture of post or teeth. In now days new post removal technique using ATD automatic bridge remover was introduced. Advantages of this method are simple and short time consuming compare to others. This article served as a successful case report of post removal using ATD automatic bridge remover.

Conservative infection control on acute pericoronitis in mandibular third molar patients referred from the prison (교도소에서 의뢰된 급성 하악 지치 주위염의 보존적 감염관리: 증례보고)

  • Lee, Chun-Ui;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Kim, Ha-Rang;Mo, Dong-Yub;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.1
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    • pp.57-61
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    • 2010
  • In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.

Matrix metalloproteinase-8 and substance P levels in root canal exudates of nonvital teeth (근관 삼출액에서의 기질금속단백분해효소-8과 substance P의 수준에 관한 연구)

  • Shin, Su-Jung;Lee, Woo-Cheol;Lee, Jae-Il;Baek, Seung-Ho;Kum, Kee-Yeon;Shon, Won-Jun;Bae, Kwang-Shik
    • Restorative Dentistry and Endodontics
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    • v.36 no.3
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    • pp.196-202
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    • 2011
  • Objectives: The aim of this study was to investigate levels of matrix metalloproteinase-8 (MMP-8) and substance P (SP) in root canal exudates during root canal treatment (RCT) of nonvital, painful teeth. Materials and Methods: Patients scheduled for nonsurgical RCT were prospectively selected; the study was performed after obtaining informed consent from the patients and was approved by the Institutional Review Board for Clinical Research of Gangnam Severance Hospital, Yonsei University (3-2008-0118). Canal exudates samples were collected using sterilized paper points from teeth scheduled for RCT across three different time periods. MMP-8 and SP levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using a mixed model analysis and the Pearson correlation analysis (p < 0.05). Results: MMP-8 and SP levels in GCF were decreased during RCT (p < 0.0001), and they showed a weak positive correlation to each other (p < 0.05). Patients' subjective pain levels and the response from percussion test were significantly related to SP level. Conclusions: This study demonstrated that periradicular inflammation endodontic origin can elevate SP and MMP-8 levels in root canal exudates. Interestingly, SP level of canal exudates showed a possibility of being used as an indicator of pain due to periapical pathosis.